RESUMEN
After a 2-year-old male with left impairment underwent surgery for a left vesicoureteral stenosis, his renal function was followed up by means of dynamic renal scintigraphy with 99mTc-DTPA. Incidental radiotracer accumulation was observed in left hemiabdomen tracing the descending and sigmoid colon. A vesico-colonic fistula was suspected. However, ultrasonography and cystography studies showed no presence of a vesico-enteric fistula. Because the patient persisted without symptoms, an expectant approach was adopted. One year later, he began to suffer watery diarrhoea episodes. 99mTc-DTPA renography was again performed to re-evaluated renal function and explore presence of urinary-enteric fistula. Diuretic renography demonstrated the presence of a vesical leak to sigmoid gut, which was confirmed by recovery of fecal matter from the patient. Both isotopic renograms evidenced the presence of uretero-sigmoid fistula, an uncommon postsurgical that was not detected by cystography, ultrasonography or RMN. The patient subsequently underwent surgery for fistula repair.
Asunto(s)
Fístula Intestinal/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Enfermedades del Sigmoide/diagnóstico por imagen , Enfermedades Ureterales/diagnóstico por imagen , Fístula Urinaria/diagnóstico por imagen , Preescolar , Diuréticos , Extravasación de Materiales Terapéuticos y Diagnósticos/diagnóstico por imagen , Extravasación de Materiales Terapéuticos y Diagnósticos/etiología , Reacciones Falso Negativas , Humanos , Fístula Intestinal/cirugía , Masculino , Complicaciones Posoperatorias/cirugía , Cintigrafía , Radiofármacos , Segunda Cirugía , Enfermedades del Sigmoide/cirugía , Pentetato de Tecnecio Tc 99m , Enfermedades Ureterales/cirugía , Obstrucción Ureteral/congénito , Obstrucción Ureteral/cirugía , Fístula Urinaria/cirugíaRESUMEN
OBJECTIVE: To study the effects of serum lipid levels by isocaloric substitution of whole milk intake in a group of children with a milk preparation (fat-free milk enriched with oleic acid containing a small amount of cholesterol) that is frequently consumed in our community. DESIGN: A crossover clinical trial was carried out with random selection. There were 88 children of both sexes, ranging in age from 3 to 9 years, selected at a Primary Care Center. The children were divided into two homogeneous groups. The first group consumed whole milk for the first 7-month study period, whereas the second group drank the milk substitute. At the end of the first test period, serum lipid levels were measured. Then the type of diet was reversed: Group 1 children consumed the milk substitute whereas Group 2 children drank whole milk. The rest of their intake did not vary throughout the study. At the end of the second 7-month period we measured serum lipid levels again. The levels of serum lipid evaluated were total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, Apoprotein A1, Apoprotein B, and lipoprotein (a). For the statistical analysis the nonpaired and paired t tests were used. RESULTS: The mean level of cholesterol after taking whole milk was 4.53 mmol/L (175.26 mg/dl), and the mean level after taking the milk preparation was 4.2 mmol/L (162.65 mg/dl), which indicates a 7.2% decrease. The mean level of low-density lipoprotein cholesterol after whole milk intake was 2.73 mmol/L (106.1 mg/dl), whereas after consuming the milk preparation it was 2.47 mmol/L (96.1 mg/dl), which indicates a decrease of 9.5%. Triglycerides were reduced from 0.83 mmol/L (73.53 mg/dl) after whole milk to 0.72 mmol/L (63.79 mg/dl) after the milk substitute, which suggests a 13.25% decrease. High-density lipoprotein cholesterol, apoprotein A1, apoprotein B, and lipoprotein (a) did not undergo any significant change. CONCLUSIONS: To reduce serum levels of total cholesterol and low-density lipoprotein cholesterol, without reducing caloric intake, it may be beneficial to substitute the whole milk customarily consumed by children with a milk preparation of fat-free milk enriched with oleic acid.
Asunto(s)
Colesterol/sangre , Leche/metabolismo , Ácido Oléico/metabolismo , Animales , Niño , Preescolar , LDL-Colesterol/sangre , Estudios Cruzados , Dieta con Restricción de Grasas , Femenino , Humanos , Masculino , Evaluación NutricionalRESUMEN
A rapid and reproducible model of fatty liver in rats was developed by injecting corn oil (s.c.). In preliminary experiments, the mortality due to acute ethanol intoxication was significantly higher in this model of acutely fattened animals. Lipid peroxidation is a process that involves free radicals and consumes as substrate unsaturated fatty acids, which are present in great amounts in corn oil. Thus, in this work we explored whether the acute loads of corn oil increased hepatic lipid peroxidation. The three markers of cellular oxidative stress measured in fatty livers from rats injected with corn oil were: the production of thiobarbituric acid-reactive substances (TBARS), liver content of triacylglycerides (TAG), and total glutathione (GSH-GSSG). All were significantly modified. We also studied the effect of butylated hydroxytoluene (BHT), a free radical scavenger frequently used in the food industry to prevent lipid oxidation, and found that it prevented the effect of corn oil on TBARS and TAG but enhanced the depletion of GSH-GSSG caused by the acute administration of large loads of corn oil.
Asunto(s)
Hidroxitolueno Butilado/farmacología , Aceite de Maíz/toxicidad , Hígado Graso/prevención & control , Depuradores de Radicales Libres/farmacología , Vehículos Farmacéuticos/toxicidad , Animales , Hígado Graso/inducido químicamente , Hígado Graso/metabolismo , Glutatión/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Hígado/efectos de los fármacos , Hígado/metabolismo , Masculino , Ratas , Ratas Wistar , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Triglicéridos/metabolismoRESUMEN
PURPOSE: To report a patient with primary squamous carcinoma of the rectum. CASE REPORT: A 40-year-old woman with hematochezia and change in bowel habits was studied. The main laboratory finding was a mild anemia. A barium enema and a proctoscopy revealed a rectal neoplasm at eight cm from the anal verge. A transendoscopic biopsy demonstrated an squamous rectal carcinoma. A transrectal ultrasound and CT scan of the abdomen revealed a big rectal mass with transmural affection and possible involvement of the lymph nodes. The carcinoembriogenic antigen (CEA) was high (32 ng/mL). The patient underwent radiotherapy with 46 Gy, and 5-fluorouracil as radiosensitizer. Three months later, a new CT scan showed significant reduction of the size of the mass, and the patient underwent a very low anterior resection with double-stapled anastomosis. The analysis of the specimen showed a squamous carcinoma of the mid-rectum, invading through the wall without lymph node affection and with proximal, distal, and radial margins free of tumor. The CEA returned to normal after surgery (1.3 ng/mL). The patients is alive and without evidence of disease 18 months after the operation. CONCLUSION: Primary squamous carcinoma of the rectum is a rare disease, and surgery seems to be a good option of treatment, with the possibility of sphincter preservation depending upon the location of the tumor.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias del Recto , Adulto , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Femenino , Humanos , Neoplasias del Recto/diagnóstico , Neoplasias del Recto/terapiaRESUMEN
BACKGROUND: Mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. It may be caused by benign or malignant diseases. AIM: To report and discuss four cases with mucocele. REPORT OF CASES: The main clinical manifestations were abdominal pain and changes in the bowel habits. In two cases, appendiceal mucocele was an incidental finding in the diagnostic work-up or operation for acute diverticulitis and acute cholecystitis, respectively. The diagnostic approach included barium enema and CT scan of the abdomen. In three cases, the mucocele was secondary to mucinous cystadenoma; two of them had a preoperative diagnosis of mucocele and underwent colonic preparation and right hemicolectomy, one patient underwent appendectomy alone. The remaining case underwent appendectomy alone, was found to have mucinous adenocarcinoma, and underwent a right hemicolectomy in a second operation. Postoperative outcome was adequate in all cases. CONCLUSION: Mucocele of the vermiform appendix is a rare disease. An appendectomy is an adequate treatment for benign disease. If malignant disease is demonstrated, a right hemicolectomy should be performed.
Asunto(s)
Apéndice , Mucocele , Adulto , Anciano , Anciano de 80 o más Años , Apendicectomía , Neoplasias del Apéndice/complicaciones , Neoplasias del Apéndice/diagnóstico , Neoplasias del Apéndice/cirugía , Enfermedades del Ciego/diagnóstico , Enfermedades del Ciego/etiología , Enfermedades del Ciego/cirugía , Colectomía , Cistoadenoma Mucinoso/complicaciones , Cistoadenoma Mucinoso/diagnóstico , Cistoadenoma Mucinoso/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucocele/diagnóstico , Mucocele/etiología , Mucocele/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Asthma is one of the most frequent chronic diseases in children. Its epidemiological tendency is of great importance. In this study, we evaluated the statistical information available from 1987 to 1994 on childhood asthma from several medical institutions in Mexico. We found that: 1) the frequency of medical care provided to asthmatic children under the age of 15 in outpatient, emergency and within hospital settings, expressed as a percentage of the total care provided for each category, has remained unchanged in almost all of the institutions reviewed, whereas the national mortality rate due to asthma has decreased from 3.5/100,000 inhabitants in 1987 to 2.9 in 1993, 2) the frequency of healthcare provided to asthmatics decreases between the ages of 15 to 24; 3) the disease occurs more frequently among males under 15 and in females over that age, 4) from August to November there was a significant rise in care provided for asthmatics in outpatient, emergency and hospital settings in Mexico City and almost every state studied; and 5) the frequency of care for asthmatics increases according to an increase in geographical altitude levels.
Asunto(s)
Asma/epidemiología , Adolescente , Adulto , Distribución por Edad , Asma/mortalidad , Niño , Preescolar , Urgencias Médicas , Humanos , Lactante , México/epidemiología , Distribución por SexoRESUMEN
A fluorescence assay was used to measure the interaction of myelin basic protein (MBP) with monomeric actin labeled with a fluorescent compound (IAEDANS). The complex actin-IAEDANS increase the fluorescence in presence of MBP. The enhancement of the fluorescence has a sigmoidal dependence on the concentration of MBP and the fluorescence maximum is reached at a MBP:actin molar ratio of 1:20. The fluorescence maximum in absence of Ca2+ and ATP is 4 times lower than that in their presence although it is reached at the same MBP:actin molar ratio. Similar behavior is observed when synapsin replaces MBP, while acetylated MBP and bovine serum albumin fail to induce any fluorescence change. To define possible interacting domains on MBP involved in the actin-MBP interaction, experiments were performed using MBP-derived peptides obtained under controlled proteolysis of the whole molecule. The fluorescence changes induced by the different peptides depend on their location in the native protein and can not be explained simply by a difference in the net charge of the peptides. The results suggest that two sites are involved in the interaction. A Ca2+/ATP-dependent site located in the amino-terminal region (peptide 1-44) and a Ca2+/ATP-independent one near the carboxyl terminus of the MBP molecule. The actin-MBP interaction was also observed using immunoblot and ELISA techniques.
Asunto(s)
Actinas/metabolismo , Proteína Básica de Mielina/metabolismo , Actinas/química , Animales , Sitios de Unión , Bovinos , Colorantes Fluorescentes , Sueros Inmunes , Músculos/metabolismo , Proteína Básica de Mielina/química , Naftalenosulfonatos , Fragmentos de Péptidos/química , Fragmentos de Péptidos/metabolismo , Conformación Proteica , Conejos , Espectrometría de Fluorescencia , Médula Espinal/metabolismo , Sinapsinas/metabolismoRESUMEN
The Cooper is test (running 1609 m) was applied to 1196 students, 15 to 17 years old, performed the Cooper's test (1609 m race). The scale, designed adequately for this sample of Mexican population, allows to judge the physical fitness by means of an easy and economical procedure.
Asunto(s)
Aptitud Física , Carrera , Estudiantes , Población Urbana , Adolescente , Altitud , Análisis de Varianza , Antropometría , Humanos , México/epidemiología , Microcomputadores , Fumar/epidemiología , Estudiantes/estadística & datos numéricos , Factores de Tiempo , Población Urbana/estadística & datos numéricosRESUMEN
BACKGROUND: Concealed retrograde activation has been proposed as a mechanism for antegrade conduction block in the bundle branches and atrioventricular accessory pathways. We studied this hypothesis (linking) in 10 patients with the Wolff-Parkinson-White syndrome in whom antegrade preexcitation could be persistently blocked by overdrive atrial pacing. METHODS AND RESULTS: An atrial pacing protocol, with a decremental ramp followed by an incremental ramp, defined a range of atrial paced cycle lengths (linking window) associated with both persistent conduction and block in the accessory pathway. Within the limits of the linking window, the ability of an atrial impulse to conduct over the accessory pathway was dependent on the preceding state (i.e., conduction or block). The observed linking window ranged from 70 to 290 msec (mean, 185 +/- 68 msec) and closely approximated the measured delay in retrograde activation of the accessory pathway during persistent antegrade block. The mean antegrade effective refractory period of the accessory pathways was long (486 +/- 156 msec), and in each case, it exceeded the antegrade refractory period of the normal atrioventricular pathway. Critically timed premature ventricular extrastimuli, delivered while linking was maintained in the accessory pathway, were able to interrupt the linking and restore antegrade accessory pathway conduction. CONCLUSIONS: These observations suggest that accessory pathway linking is associated with bidirectional block in the accessory pathway. The ability to initiate linking (and the stability of the phenomenon) depends on a critical relation between antegrade accessory pathway refractoriness and the magnitude of retrograde accessory pathway activation delay.
Asunto(s)
Bloqueo de Rama/fisiopatología , Estimulación Cardíaca Artificial , Sistema de Conducción Cardíaco/fisiopatología , Síndrome de Wolff-Parkinson-White/fisiopatología , Adulto , Nodo Atrioventricular/fisiopatología , Bloqueo de Rama/etiología , Cateterismo Cardíaco , Complejos Cardíacos Prematuros/etiología , Electrocardiografía/métodos , Electrofisiología , Femenino , Humanos , MasculinoRESUMEN
The strong inhibition of thymocyte-RNA synthesis by 11 beta-hydroxypregna-1, 4-diene-3, 20-dione (delta HOP) reported recently, fulfills the three conditions required for a non-genomic effect, i.e.: no persistence upon washing out, instantaneous action and effect in the presence of inhibitors of RNA synthesis. Injection of (delta HOP) into mice (2 mg/100 g) also causes a 32% inhibition in their thymocyte-RNA synthesis, but the mechanism of this latter inhibition has still not been clarified.
Asunto(s)
Hidroxiprogesteronas/farmacología , ARN/biosíntesis , Timo/citología , Uridina/metabolismo , Animales , Medios de Cultivo , Ratones , Ratones Endogámicos BALB C , Biosíntesis de Proteínas , Ratas , Ratas Endogámicas , Timo/metabolismoRESUMEN
The strong inhibition of thymocyte-RNA synthesis by 11 beta-hydroxypregna-1, 4-diene-3, 20-dione (delta HOP) reported recently, fulfills the three conditions required for a non-genomic effect, i.e.: no persistence upon washing out, instantaneous action and effect in the presence of inhibitors of RNA synthesis. Injection of (delta HOP) into mice (2 mg/100 g) also causes a 32
inhibition in their thymocyte-RNA synthesis, but the mechanism of this latter inhibition has still not been clarified.
Asunto(s)
Bloqueadores de los Canales de Calcio/farmacología , Nodo Sinoatrial/efectos de los fármacos , Vasodilatadores/farmacología , Verapamilo/farmacología , Adulto , Sistema Nervioso Autónomo/fisiopatología , Electrocardiografía , Humanos , Masculino , Nodo Sinoatrial/fisiopatología , Vasodilatadores/administración & dosificación , Vasodilatadores/efectos adversosRESUMEN
Es presentado un paciente de 25 anos de edad con disfuncioon del nodulo sinusual debia a hipertonia vagal, estudiando con la tecnica de estimulacion auricular transesogafica. Las respuesta a la administracion de atropina fue un incremento de la frecuencia sinusal sobre el valor minimo normal establecido y una preservacion de la conduccion auriculo-ventricular a una frecuencia que previamente habia mostrado fenomeno de Wenckebach. La administracion intravenosa de verapamil mostro una inesperada reaccion. El tiempo de recuperacion del nodulo sinusal corregido regreso al valor normal a la misma frecuencia de estimulacion utilizada en el estudio control Otra interesante observacion fue el desplazamiento del bloqueo de 2o. grado tipo Wanckebach a una frecuencia de estimulacion mas alta. La respuesta usual a la administracion de verapamil es el empeoramiento de la conduccion en aquellas estructuras y no su mejoria. Estos hallazgos sugieren en este paciente la predominancia de los efectos indirectos del verapamil sobre la accion depresora de esta droga
Asunto(s)
Adulto , Humanos , Masculino , Frecuencia Cardíaca , Nodo Sinoatrial , Verapamilo , ElectrocardiografíaRESUMEN
Es presentado un paciente de 25 anos de edad con disfuncioon del nodulo sinusual debia a hipertonia vagal, estudiando con la tecnica de estimulacion auricular transesogafica. Las respuesta a la administracion de atropina fue un incremento de la frecuencia sinusal sobre el valor minimo normal establecido y una preservacion de la conduccion auriculo-ventricular a una frecuencia que previamente habia mostrado fenomeno de Wenckebach. La administracion intravenosa de verapamil mostro una inesperada reaccion. El tiempo de recuperacion del nodulo sinusal corregido regreso al valor normal a la misma frecuencia de estimulacion utilizada en el estudio control Otra interesante observacion fue el desplazamiento del bloqueo de 2o. grado tipo Wanckebach a una frecuencia de estimulacion mas alta. La respuesta usual a la administracion de verapamil es el empeoramiento de la conduccion en aquellas estructuras y no su mejoria. Estos hallazgos sugieren en este paciente la predominancia de los efectos indirectos del verapamil sobre la accion depresora de esta droga